Researchers indicate that about 12% of all gastrointestinal surgeries result in surgical site infections worldwide, placing patients at additional risk that could be avoided, according to the findings of a new study.

A group of surgeons from around the world, known as the GlobalSurg Collaborative, published a report in the medical journal Lancet Infectious Diseases on February 13, indicating that more than one-in-10 gastrointestinal surgeries lead to infections, and that the overuse of antibiotics may be a contributing factor.

The study warns that in one-fifth of cases, infections were resistant to pre-surgery antibiotics worldwide, with the rate as high as one-third of cases in low income countries.

“Surgical site infection (SSI) is a large health burden for patients and health-care providers,” the researchers noted. “It is the most common postoperative complication and causes pain and suffering to patients.”

The international, prospective, multicenter cohort study involved data on more than 12,500 patients in 66 countries nationwide who had gastrointestinal surgery. Researchers looked at rates of infection occurring within two weeks of the surgery from January 4, 2016, through July 31, 2016.

According to the findings, the nation’s income played a significant role, with countries ranking high on the Human Development Index (HDI), meaning they had a relatively high income and access to advanced medical treatment, like the United States, averaging about a 9% infection rate. Middle income countries had a 14% infection rate, while less developed countries had infection rates of higher than 23%. Infections that were antibiotic resistant were detected in more than 16% of cases in high income countries, nearly 20% in middle income countries, and almost 36% of cases in low income countries.

Researchers found that the failure to use a surgical safety checklist was linked to a high rate of surgical site infections. They also called for the careful implementation of World Health Organization recommendations on preventing surgical site infections, noting that the cost of preventative measures may be offset by the cost savings from having less infection incidents, and could reduce antibiotic overuse, which has become a major health concern in recent years.

Many infections that were once treated with antibiotics are now resistant to those same drugs. Researchers estimate nearly 700,000 people around the world die from drug-resistant bacteria every year. A 2014 British report warned that antibiotic resistant bacteria will cause more than 10 million deaths globally every year by the year 2050, unless drastic measures are taken to mitigate the growing problem.

Other research indicates more than 23,000 Americans die each year from antibiotic resistant bacteria and 2 million become sick due to the so called superbugs every year.